Kowalczyk T D, Cabaniss M L, Cusmano L
Department of Obstetrics and Gynecology, Mountain Area Health Education Center, Asheville, North Carolina 28801, USA.
Obstet Gynecol. 1998 Mar;91(3):396-400. doi: 10.1016/s0029-7844(97)00677-7.
To investigate the association between a low unconjugated estriol (uE3) in the second trimester and adverse pregnancy outcomes.
Three hundred nine women who underwent second-trimester maternal serum alpha-fetoprotein (AFP)-hCG-uE3 screening were divided into two groups: those with uE3 at most 0.75 multiples of the median (MoM) (n = 81) and those with uE3 exceeding 0.75 MoM (n = 228). Entry criteria included: hCG below 2 MoM, AFP below 2 MoM, age less than 35 years at delivery, complete prenatal records, and completed delivery. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for a variety of adverse pregnancy outcomes.
After adjusting for smoking and hCG, women with uE3 at or below 0.75 MoM were found to have significantly higher odds of developing fetal growth restriction, low amniotic fluid index (AFI), and small for gestational age (SGA) with ORs (and 95% CIs) of 6.73 (2.55, 17.74), 3.85 (1.53, 9.68), and 2.89 (1.27, 6.57), respectively, for each of the outcomes.
Low uE3 in the second trimester appears to be associated with fetal growth restriction, low AFI, and SGA, and the risk seems to be independent of risk for adverse infant outcome associated with elevated AFP or hCG.
探讨孕中期游离雌三醇（uE3）水平低与不良妊娠结局之间的关联。
309例行孕中期母血清甲胎蛋白（AFP）-人绒毛膜促性腺激素（hCG）-uE3筛查的妇女被分为两组：uE3水平至多为中位数倍数（MoM）的0.75倍者（n = 81）和uE3水平超过0.75 MoM者（n = 228）。纳入标准包括：hCG低于2 MoM，AFP低于2 MoM，分娩时年龄小于35岁，完整的产前记录，以及完成分娩。计算各种不良妊娠结局的比值比（OR）和95%置信区间（CI）。
在对吸烟和hCG进行校正后，发现uE3水平在0.75 MoM及以下的妇女发生胎儿生长受限、羊水指数（AFI）低和小于胎龄儿（SGA）的几率显著更高，每种结局的OR（及95%CI）分别为6.73（2.55，17.74）、3.85（1.53，9.68）和2.89（1.27，6.57）。
孕中期uE3水平低似乎与胎儿生长受限、AFI低和SGA有关，且该风险似乎独立于与AFP或hCG升高相关的不良婴儿结局风险。
